Surgical stapler with removable power pack

ABSTRACT

A surgical fastener applier including a housing containing a compartment, an elongated member extending distally from the housing, first and second jaws and a firing mechanism positioned within the housing. The firing mechanism is movable between a first position and a second position to effect firing of fasteners into the tissue clamped between the first and second jaws. A cover on the housing is openable to access the compartment. A power pack is removably loadable into the compartment, the power pack having a motor and an engagement member removably engageable with the firing mechanism within the compartment when the power pack is loaded into the compartment to effect movement of the firing mechanism from the first position to the second firing position.

This application claims priority from provisional application Ser. No.62/553,297, filed Sep. 1, 2017 and from provisional application Ser. No.62/616,045, filed Jan. 11, 2018. The entire contents of each of theseapplications are incorporated herein by reference.

BACKGROUND OF THE INVENTION 1. Field of the Invention

This application relates to surgical staplers, and more particularly, tosurgical staplers having removable power packs to effect firing of thestaples.

2. Background

Surgical staplers are used in various medical applications where adevice is needed to join and dissect anatomical tissue. However, thereare drawbacks and costs associated with use of surgical staplers.Currently staplers are either fully disposable, reusable or partiallyreusable. Due to contamination during the surgical procedure, e.g.,exposure to the patient's body fluids, the staplers are required to besterilized after use, a time consuming and expensive process, withpossible risks of infection if not properly sterilized as contaminantsadhered to the surgical stapler from a previous use could be transferredto another patient. To avoid the risks of resterilization, some surgicalstaplers are disposed after use in the surgical procedure. Thesestaplers can be reloaded to fire multiple cartridges of staples, butafter the procedure, the staplers are discarded. However, the practiceof using single use disposable surgical staplers is costly.

In certain procedures, high forces are required to fire the staplesthrough tissue into contact with the anvil for formation This iscompounded when multiple rows of staples are fired either simultaneouslyor sequentially from the stapler. Therefore, powered staplers have beenintroduced to reduce the force requirements of the user. Such poweredstaplers have motor driven mechanisms (assemblies) to advance componentswithin the stapler to fire the staples from the cartridge throughtissue. Such powered staplers, if reusable, are subject to the sameaforementioned costs and risk of resterilization. However they sufferfrom additional drawbacks since the sterilization process and/or heat orchemicals used in the sterilization process can damage the electroniccomponents of the drive assemblies, which may shorten the lifespan ofthe surgical stapler or adversely affect its function if resterilizationcompromises the function of the motor or drive assembly. If the stapleris disposable, the stapler becomes more costly since the electroniccomponents, which add to the cost of the stapler, are also discardedwith the stapler.

It would be advantageous to provide a cost effective, efficient, simpleto use and advanced assemblies for powering surgical instruments whichovercome the drawbacks of manual actuation without suffering from thedisadvantages of current power driven staplers.

SUMMARY

The present invention overcomes the deficiencies and disadvantages ofthe prior art. The present invention advantageously provides surgicalstaplers that overcome the drawbacks discussed above by having a fullyenclosed and removable power pack. The surgical staplers according tothe present disclosure may be used multiple times without the need tosterilize the power pack between uses because the power pack is fullyenclosed and sealed by the surgical stapler handle assembly or housing,thereby preventing contact between the power pack and the patient and/orpatient's bodily fluids or the like. Thus, the surgical staplers of thepresent disclosure advantageously reduce the time, resources and/orcosts for preparing the surgical stapler for its next use. The presentdisclosure also provides power packs that are cost effective, efficientand easily loadable into surgical staplers where they engage structurein the housing to effect varied functions of the stapler.

In accordance with one aspect of the present disclosure, a surgicalfastener applier is provided comprising a housing containing acompartment therein and an elongated member extending distally from thehousing. A first jaw and a second jaw are positioned at a distal portionof the elongated member, wherein at least the first jaw is movable withrespect to the second jaw to clamp tissue between the first and secondjaws. A firing mechanism is positioned within the housing and is movablebetween a first position and a second firing position, wherein in thesecond position, the firing mechanism effects firing of fasteners intothe tissue clamped between the first and second jaws. A cover on thehousing is openable to access the compartment within the housing and apower pack is removably loadable into the compartment, the power packhaving a motor and an engagement member removably engageable with thefiring mechanism within the compartment when the power pack is loadedinto the compartment to effect movement of the firing mechanism from thefirst position to the second firing position.

In some embodiments, a first seal to seal about the cover in the closedposition is provided to protect the power pack positioned within thehousing and/or the apparatus includes a second seal to block passage ofbody fluids from the elongated member into the compartment.

In some embodiments, the power pack has a housing and one of the housingor the compartment has at least one external rib and another of thehousing or the compartment has at least one groove to receive the rib toguide the power pack within the compartment. Other guide structurescould alternatively be provided.

In some embodiments, the power pack includes a second engagement memberremovably engageable with an articulating mechanism of the surgicalfastener applier to effect articulation of the first and second jawsfrom a linear position to a position angled with respect to alongitudinal axis of the elongated member. The power pack can include asecond motor and the second motor can effect linear movement of thearticulation mechanism of the surgical fastener applier.

In some embodiments, the power pack includes a gear mechanism powered bythe motor, wherein rotation of a motor shaft of the motor effectsrotation of the gear mechanism which effects linear movement of thefiring mechanism of the surgical fastener applier. In other embodiments,the power pack includes a drive belt powered by the motor, whereinrotation of a motor shaft of the motor effects rotation of a first discwhich moves the drive belt to effect linear movement of the firingmechanism of the surgical fastener applier.

In accordance with another aspect of the present disclosure, a surgicalfastener applier is provided comprising a housing containing acompartment therein, an elongated member extending distally from thehousing and a jaw assembly including a first jaw and a second jaw at adistal portion of the elongated member wherein at least the first jaw ismovable with respect to the second jaw. A jaw clamping mechanism ismovable between a first position and second position to move at leastthe first jaw toward the second jaw to clamp tissue between the firstand second jaws. A firing mechanism is movable between a first positionand a second firing position to fire fasteners into the tissue clampedbetween the first and second jaws. An articulation mechanism is movablebetween a first position and a second position to articulate the jawassembly from a linear position to a second position angled with respectto a longitudinal axis of the elongated member. A cover on the housingis movable from a closed position to an open position to access thecompartment. A power pack is loadable into the compartment, the powerpack having a motor and an engagement member engageable with thearticulation mechanism to effect movement of the articulation mechanismfrom the first position to the second position.

In some embodiments, the power pack includes a gear mechanism for movinga drive mechanism linearly to move the articulation mechanism linearlyto articulate the jaw assembly. In other embodiments, the power packincludes a drive belt for moving a drive mechanism linearly to move thearticulation mechanism linearly to articulate the jaw assembly.

In accordance with another aspect of the present disclosure, a methodfor powering a surgical stapler is provided comprising the steps of:

-   -   providing a surgical stapler having a housing containing a        compartment and a cover movable between a closed position and an        open position;    -   loading a power pack having a drive mechanism into the        compartment when the cover is in the open position, wherein the        step of loading the power pack releasably engages the drive        mechanism with a firing mechanism in the housing;    -   closing the cover to seal the compartment from an external        environment;    -   actuating the motor to move the drive mechanism linearly to        thereby move the firing mechanism linearly to advance a        plurality of staples into body tissue; and    -   after advancing the staples, opening the cover and removing the        power pack from the compartment to release the engagement of the        drive mechanism from the firing mechanism.

In some embodiments, the surgical stapler has first and second jawsmovable from an open position to a closed by position by manual movementof a handle.

In some embodiments, the step of loading a power pack into thecompartment releasably engages a second drive mechanism of the powerpack with an articulation mechanism in the housing.

In accordance with another aspect of the present invention, a power packis provided removably loadable into a housing of a surgical instrument,the power pack comprising a motor having a motor shaft, a rotatable discoperably connected to the motor shaft, a drive mechanism operablyconnected to the rotatable disc, and an engagement member linearlymovable by the drive mechanism. The engagement member is configured toremovably engage an axially movable member in the housing of thesurgical instrument, wherein actuation of the motor causes linearmovement of the engagement member to effect movement of the axiallymovable member in an axial direction.

In some embodiments, the rotatable disc is engageable with a drive beltto move the drive mechanism in an axial direction. In some embodiments,the rotatable disc is a gear for moving the drive mechanism axially.

In some embodiments, a second engagement member is provided which isconfigured to engage a second axially movable member in the housing ofthe surgical instrument. A second motor and second rotatable disk can beprovided for moving the second engagement member axially.

In some embodiments, the first motor is configured to drive a pluralityof staples through tissue and the second motor is configured toarticulate jaws of the surgical instrument to an angled position withrespect to the instrument. In some embodiments, the first motor isconfigured to move the jaws of the surgical instrument between an openand closed position.

In accordance with another aspect of the present disclosure, a surgicalinstrument is provided comprising a housing containing a compartmenttherein, an elongated member extending distally from the housing, and afirst jaw and a second jaw at a distal portion of the elongated member,at least the first jaw movable with respect to the second jaw. Anadvancing mechanism is positioned within the housing and is movablebetween a first position and a second position. A cover on the housingis openable to access the compartment within the housing. A power packis loadable into the compartment, the power pack having a motor and anengagement member engageable with the advancing mechanism within thecompartment when the power pack is loaded into the compartment to effectmovement of the advancing mechanism from the first position to thesecond position.

In some embodiments, the advancing mechanism is operably connected to atleast one of the first and second jaws, wherein movement of the jawadvancing mechanism effects closing of the first and second jaws. Inother embodiments, movement of the advancing mechanism effects firing ofat least one fastener into the tissue clamped between the first andsecond jaws.

In some embodiments, the power pack has a second motor and a secondengagement member engageable with a second advancing mechanismpositioned within the housing of the instrument when the power pack isloaded into the compartment to effect movement of the second advancingmechanism from the first position to the second position.

In accordance with another aspect of the present disclosure, a surgicalinstrument is provided comprising a housing containing a compartmenttherein configured to receive a power pack, an elongated memberextending distally from the housing and a first jaw and a second jaw ata distal portion of the elongated member, at least the first jaw movablewith respect to the second jaw to clamp tissue between the first andsecond jaws. A firing mechanism is positioned within the housing, thefiring mechanism movable between a first position and a second firingposition, wherein in the second position, the firing mechanism effectsfiring of at least one fastener into the tissue clamped between thefirst and second jaws. A cover is mounted on the housing movable from aclosed position to an open position to access the compartment within thehousing, the cover in the closed position sealing the compartment fromthe external environment to protect a power pack when loaded therein. Afirst seal is provided to prevent flow of body fluids into thecompartment from the elongated member to protect the power pack whenloaded in the compartment.

In some embodiments, the housing contains a firing rod positionedtherein to removably receive an engagement member of the power pack whenloaded therein for motorized advancement of the firing rod to effectfiring of at least one fastener supported in the instrument.

BRIEF DESCRIPTION OF THE DRAWINGS

So that those having ordinary skill in the art to which the subjectinvention appertains will more readily understand how to make and usethe surgical apparatus disclosed herein, preferred embodiments thereofwill be described in detail hereinbelow with reference to the drawings,wherein:

FIG. 1 is a perspective view of a first embodiment of the surgicalstapler of the present disclosure having a removable power pack;

FIG. 2A is a side view of the surgical stapler of FIG. 1;

FIG. 2B is a bottom view of the surgical stapler of FIG. 1;

FIG. 2C is a front view of the surgical stapler of FIG. 1A:

FIG. 3A is a perspective view of the surgical stapler of FIG. 1 showingthe handle compartment cover in the open position and further showingthe power pack prior to insertion into the handle compartment;

FIG. 3B is front view of the surgical stapler of FIG. 3A showing thehandle compartment cover in the open position;

FIG. 3C is a front view of the power pack of FIG. 3A;

FIG. 3D is a top perspective view of the surgical staple of FIG. 3Ashowing the compartment for receiving the power pack;

FIG. 4A is a top view of the motor and drive mechanism (assembly) of thepower pack of FIG. 3A;

FIG. 4B is a side view of the motor and drive mechanism of the powerpack of FIG. 4A;

FIG. 4C is a top view of the power pack of FIG. 3A;

FIG. 4D is a side view of the motor and drive mechanism of FIG. 4A shownengaged with the rod of the firing assembly of the surgical stapler ofFIG. 1;

FIG. 4E is a perspective view of the motor and drive mechanism of thepower pack of FIG. 3A;

FIG. 4F is a cross-sectional view taken along line AY-AY of FIG. 4Cshowing the power pack engaging the firing rod of the surgical staplerof FIG. 1;

FIG. 4G is a side view of the power pack of FIG. 3A;

FIG. 4H is a cross-sectional view taken along line AT-AT of FIG. 4G;

FIG. 41 is a top view of the surgical stapler of FIG. 1;

FIG. 5A is a schematic view illustrating transition from rotationalmovement to linear movement to effect a function of the surgicalstapler;

FIG. 5B is a schematic view of an alternate embodiment illustratingtransition from rotational movement to linear movement to rotationalmovement to effect a function of the surgical stapler;

FIG. 6A is a side view of the surgical stapler of FIG. 1 showing thehandle compartment cover in the open position and further showing thepower pack in the process of being inserted in the compartment of thehandle;

FIG. 6B is a bottom view of the surgical stapler of FIG. 6A;

FIG. 6C is a cross-sectional view taken along line A-A of FIG. 6B;

FIG. 6D is a close up view of the area of detail AR of FIG. 6C;

FIG. 7A is a top view of the surgical stapler of FIG. 1 with the powerpack fully inserted into the compartment in the handle and the cover inthe closed position;

FIG. 7B is a cross-sectional view taken along line A-A of FIG. 7A;

FIG. 7C is a close up view of the area of detail B of FIG. 7B showingthe firing mechanism at the distal end for firing staples;

FIG. 8A is a top view of the surgical stapler of FIG. 1 showing thepower pack fully inserted and the cover of the handle compartment in theclosed position, the view the same as FIG. 7A but having section lineE-E;

FIG. 8B is a cross-sectional view taken along line E-E of FIG. 8A, theview being the same as FIG. 7B but having section lines F-F andidentified area of detail B;

FIG. 8C is a side view of the surgical stapler of FIG. 1 showing thepower pack fully inserted in the handle compartment and the compartmentcover closed;

FIG. 8D is a cross-sectional view taken along line J-J of FIG. 8C;

FIG. 9 is a cross-sectional view taken along line F-F of FIG. 8B;

FIG. 10 is a close up view of the area of detail G of FIG. 8B;

FIG. 11 is a close up view of the area of detail H of FIG. 9;

FIG. 12 is a close up view of the detail K of FIG. 8D;

FIG. 13A is a side view of an alternate embodiment of the surgicalstapler showing the power pack of FIG. 3A prior to insertion into thehandle compartment;

FIG. 13B is a side view similar to FIG. 13A showing the power pack ofFIG. 3A inserted into the handle compartment;

FIG. 13C is a side view of another alternate embodiment of the surgicalstapler showing the power pack of FIG. 3A prior to insertion into thehandle compartment;

FIG. 13D is a side view similar to FIG. 13C showing the power pack ofFIG. 3A inserted into the handle compartment;

FIG. 14A is a side view illustrating an alternate embodiment having apower pack for effecting both firing and articulation of the surgicalstapler, the power pack shown fully inserted into the compartment of thehandle of the surgical stapler and the compartment cover shown in theclosed position;

FIG. 14B is a top view of the surgical stapler of FIG. 14A;

FIG. 14C is a cross-sectional view taken along line C-C FIG. 14B;

FIG. 14D is a side view of the surgical stapler of FIG. 14A, the viewbeing the same as FIG. 14A but having section line M-M;

FIG. 14E is cross-sectional view taken along line M-M of FIG. 14D;

FIG. 14F is a cross-sectional view taken along line N-N of FIG. 14D;

FIG. 15A is a close up view of the area of detail D of FIG. 14C;

FIG. 15B is a close up view of the area of detail O of FIG. 14E:

FIG. 15C is a top view of the power pack of FIG. 14A for effecting bothfiring and articulation of the surgical stapler;

FIG. 15D is a cross-sectional view taken along line AW-AW of FIG. 15C;

FIG. 15E is a side view of the power pack of FIG. 14A;

FIG. 15F is a cross-sectional view taken along line AT-AT of FIG. 15E;

FIG. 16A is a top view of the surgical stapler of FIG. 14A, the viewbeing the same as FIG. 14B but having section line E-E;

FIG. 16B is a side view of the surgical stapler of FIG. 14A, the viewbeing the same as FIG. 14C but having section line F-F and identifiedarea of detail G;

FIG. 16C is a cross-sectional view taken along line F-F of FIG. 15C;

FIG. 16D is a close up view of the area of detail H of FIG. 16C;

FIG. 17 is a side view of the surgical stapler of FIG. 14A, the viewbeing the same as FIG. 14A but having section line J-J;

FIG. 18A is a cross-sectional view taken along line J-J of FIG. 17;

FIG. 18B is a close up view of the area of detail BA of FIG. 18A;

FIG. 19A is a top cutaway view of the power pack of FIG. 14A;

FIG. 19B is an enlarged view of the area of detail AK of FIG. 19A;

FIG. 19C is an enlarged view of the area of detail AL of FIG. 19A;

FIG. 20 is a cross-sectional side view of the surgical stapler of FIG.14A, the view being the same as FIG. 14C but having identified areas ofdetail Q, R and S;

FIG. 21A is an enlarged view of the area of detail Q of FIG. 20;

FIG. 21B is an enlarged view of the area of detail R of FIG. 19A;

FIG. 21C is an enlarged view of the area of detail S of FIG. 19A;

FIG. 22A is a top view of the motor and drive mechanism (assembly) ofthe power pack of FIG. 14A for effecting staple firing and articulation;

FIG. 22B is a side view of the motor and drive mechanism of the powerpack of FIG. 14A;

FIG. 22C is a side view of the motor and drive mechanism of FIG. 14Ashown engaged with the articulation rod of the articulation assembly ofthe surgical stapler of FIG. 14A;

FIG. 22D is a perspective view of the motor and drive mechanism(assembly) of the power pack of FIG. 14A;

FIG. 23A is a cross-sectional side view of the surgical stapler of FIG.14A, the view being the same as FIG. 18A but having and identified areaof detail AU;

FIG. 23B is an enlarged view of the area of detail AU of FIG. 23A;

FIG. 24A is a top view of the motor and drive mechanism (assembly) ofthe power pack of an alternate embodiment having a belt drive;

FIG. 24B is a side view of the motor and drive mechanism of FIG. 24A;

FIG. 24C is a perspective view of the motor and drive mechanism of FIG.24A;

FIG. 24D is a front view of the motor and drive mechanism of FIG. 24A;

FIG. 25A is a top view of the motor and drive mechanism (assembly) ofthe power pack of an another alternate embodiment having a belt drive;

FIG. 25B is a side view of the motor and drive mechanism of FIG. 25A;

FIG. 25C is a perspective view of the motor and drive mechanism of FIG.25A;

FIG. 25D is a front view of the motor and drive mechanism of FIG. 25A;

FIG. 26A is a top view of the motor and drive mechanism (assembly) ofthe power pack of another alternate embodiment having a belt drive;

FIG. 26B is a side view of the motor and drive mechanism of FIG. 26A;

FIG. 26C is a perspective view of the motor and drive mechanism of FIG.26A;

FIG. 26D is a front view of the motor and drive mechanism of FIG. 26A;

FIG. 27A is a top view of the motor and drive mechanism (assembly) ofthe power pack of an alternate embodiment having a belt drive;

FIG. 27B is a side view of the motor and drive mechanism of FIG. 27A;

FIG. 27C is a perspective view of the motor and drive mechanism of FIG.27A;

FIG. 27D is a front view of the motor and drive mechanism of FIG. 27A;

FIG. 28A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being a circular stapler;

FIG. 28B is a side view of the circular stapler of FIG. 28A;

FIG. 28C is a perspective view of the circular stapler of FIG. 28A;

FIG. 28D is a front view of the circular stapler of FIG. 28A;

FIG. 29A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being an open surgery linearstapler;

FIG. 29B is a side view of the linear stapler of FIG. 29A;

FIG. 29C is a perspective view of the linear stapler of FIG. 29A;

FIG. 29D is a front view of the linear stapler of FIG. 29A;

FIG. 30A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being a flexible endoscopic linearstapler;

FIG. 30B is a side view of the linear stapler of FIG. 30A;

FIG. 30C is a perspective view of the linear stapler of FIG. 30A;

FIG. 30D is a front view of the linear stapler of FIG. 30A;

FIG. 31A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being an endoscopic clip applier;

FIG. 31B is a side view of the clip applier of FIG. 31A;

FIG. 31C is a perspective view of the clip applier of FIG. 31A;

FIG. 31D is a front view of the clip applier of FIG. 31A;

FIG. 32A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being an endoscopic grasper;

FIG. 32B is a side view of the endoscopic grasper of FIG. 32A;

FIG. 32C is a perspective view of the endoscopic grasper of FIG. 32A;

FIG. 32D is a front view of the endoscopic grasper of FIG. 32A;

FIG. 33A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being an endoscopic scissor;

FIG. 33B is a side view of the endoscopic scissor of FIG. 33A;

FIG. 33C is a perspective view of the endoscopic scissor of FIG. 33A;and

FIG. 33D is a front view of the endoscopic scissor of FIG. 33A.

FIG. 34A is a top view of an alternate embodiment of the surgicalinstrument containing the power pack of FIG. 3A within the handlecompartment, the surgical instrument being a fastener applier;

FIG. 34B is a side view of the fastener applier of FIG. 34A;

FIG. 34C is a perspective view of the fastener applier of FIG. 34A; and

FIG. 34D is a front view of the fastener applier of FIG. 34A.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The present disclosure provides power packs, containing a battery andpower train, which are loadable into a surgical stapler to power variousfunctions of the surgical stapler to reduce the forces exerted by theclinician otherwise required if manual force was utilized. The presentdisclosure also provides surgical staplers designed to receive the powerpack and to interact with the power pack to effect firing of thestaplers. In some instances, the power pack can be used to effectarticulation of the jaw assembly of the stapler to pivot the jawassembly with respect to the longitudinal axis of the stapler. Each ofthese embodiments is discussed in detail below.

The power pack can also be utilized for powering endoscopic linearstaplers, other types of staplers as well as other surgical instruments.Examples of these instruments are also discussed below.

The loadable power packs of the present disclosure are mountable intothe handle housing of the surgical instrument, and are maintained in asterile environment within the surgical instrument so they can beremoved and reused. This enables the power pack to be removed from thestapler and reused in another procedure and/or instrument without thecomplexities, time, costs and risks of resterilization of the powerpack. The sealed environment of the battery and power train within thehousing also enables certain features/components to be used which mightnot otherwise be practical if sterilization of the internal power packwas required. Thus, by preventing contact between the power pack and thepatient and/or bodily fluids and the external environment,resterilization is not required. The power pack can be used withsurgical instruments discarded after use (fully disposable instruments),partially disposable surgical instruments or with fullyreusable/sterilizable instruments with the advantage that the power packneed not be discarded or sterilized. Thus, the surgical stapler of thepresent disclosure advantageously reduces the time, resources and/orcosts for preparing the surgical stapler for its next use.

The power packs are easily loadable in the surgical instrument,preferably the handle assembly or housing of the instrument, to easilyand securely engage structure in the housing to effect movement of suchstructure in the instrument. The power packs are also easilydisengageable from the structure for removal from the housing forsubsequent reuse. The power packs can be configured so they can beloadable and engageable in various types of surgical instruments. Thepower pack is fully enclosed and sealed by the handle housing so thereis no need to sterilize the power pack between uses.

Referring now to the drawings and particular embodiments of the presentdisclosure, wherein like reference numerals identify similar structuralfeatures of the devices disclosed herein, there are illustrated severalembodiments of the surgical instruments and removable power pack of thepresent disclosure.

With reference to FIGS. 1-23B, the power pack is used with endoscopiclinear staplers which are inserted through trocars and fire linear rowsof surgical staples from a cartridge through tissue into contact with ananvil which forms the individual staples. The staplers include anopenable compartment in the handle housing that enables easy loading ofthe power pack within the stapler. The staplers also provide a tightseal to protect the power pack from contaminants so that the power packdoes not need to be sterilized for multiple uses.

The power pack is engageable with a staple drive (staple firing)mechanism of the surgical stapler so that once it is loaded in thestapler, actuation of the motor within the power pack effects firing ofthe staples through tissue. In some embodiments, the power pack isengageable with an articulation mechanism wherein actuation of the motoreffects articulation of the stapler. The powered articulation can be inaddition to the powered staple firing or alternatively the stapler couldhave powered articulation and manual staple firing. A specificembodiment of such powered articulation included with powered firing isshown in FIGS. 14A-23B and discussed in detail below.

The term “surgical fasteners” as used herein encompasses staples havinglegs which are deformed by an anvil, two part fasteners wherein afastener or staple component with legs is received and retained in asecond component (retainer), and other types of fasteners which areadvanced through tissue of a patient in performing surgical procedures.

The term “proximal” as used herein denotes the region closer to the userand the term “distal” as used herein denotes the region further from theuser. The terms “top” or “upper” and “bottom” or “lower” refer to theorientation of the instruments as shown in the orientation of theinstrument in FIG. 2A, with the cover being on the top and the handleextending at the bottom.

Turning first to FIGS. 1-12, a first embodiment of the surgical staplerand removable power pack are illustrated. In this embodiment, the powerpack, which contains a battery, motor, drive mechanism and staplerengagement structure, effects firing of the surgical fasteners(staples).

The surgical stapler, also referred to herein as the or surgicalfastener applying instrument or surgical fastener applier, is designatedgenerally by reference numeral 1 and includes a proximal portion 1 a, adistal portion 1 b and an elongated or endoscopic portion 6 (alsoreferred to as an elongated tubular portion or shaft) extending betweenthe proximal portion 1 a and the distal portion 1 b. A handle assembly 2with a housing 4 (also referred to herein as a handle housing) ispositioned at the proximal portion 1 a and is configured to house andprotect internal mechanisms of the stapler including the removable powerpack when loaded (mounted) therein. At the distal portion 1 b areopposing members, i.e., jaws, 8 a, 8 b, configured to clamp andconstrain tissue during operation of the surgical stapler. At least oneof the jaws is movable with respect to the other jaw from an openposition to receive tissue between the jaws and a closed position toclamp tissue between the jaws. Thus, one of the jaws can be stationaryand the other jaw movable with respect to the stationary jaw oralternatively both jaws can move, e.g., pivot, toward each other. In theembodiment of FIG. 1, jaw 8 b, which contains at least one row ofsurgical fasteners (staples) is movable with respect to non-pivoting(stationary) jaw 8 a which contains an anvil with staple formingpockets. Jaws 8 a, 8 b are collectively referred to herein as jaws 8.The fasteners are fired (advanced) from jaw 8 b by linear movement of afiring mechanism which engages staple drivers within the jaw 8 b whichmove transverse to the longitudinal axis, i.e., transverse to thedirection of movement of the firing mechanism, to sequentially advance(from proximal to distal) the staples in the linear rows of staples fromthe jaw 8 b and through tissue to engage the anvil pockets on jaws 8 afor formation of the staples. Such firing of the staples is illustratedin FIG. 7C and discussed below.

The elongated tubular member 6 extends distally from the housing 4 andis configured to fit through a surgical port (trocar) used forlaparoscopic surgery. The endoscopic portion 6 can be of varyingdimensions and in some embodiments is configured to fit through a 10 mmtrocar, although other dimensions for fitting through other size trocarsare also contemplated such as trocars ranging from 5 mm to 15 mm. It isadvantageous to minimize the diameter of the endoscopic portion tominimize the size of the patient's incision. With the jaws 8 in theclamped position, the outer diameter of the elongated member 6 ismaintained as the cross-sectional dimension of the closed jaws 8preferably does not exceed the cross-sectional dimension (i.e.,diameter) of the tubular member 6.

The surgical stapler 1 can in some embodiments include a joint 10 thatprovides for the articulation of the opposing members 8, i.e., pivotingof the jaw assembly (jaws 8) to angular positions with respect to thelongitudinal axis of elongated member 6. Articulation can be achieved bylinear motion of elongated members extending through the endoscopicportion 6 which are slidable to angle the jaw assembly. A rotationalmember or knob 12 is configured to rotate, with respect to the handleassembly, the elongated member 6 and connected jaws 8 about the axis ofthe elongated member 6 to change the position of the jaws 8.Articulation is effected by manual manipulation of a lever adjacent thehandle 2. A handle lever 14, linked to an axially movable clamping bar,is pivotable from a first position to a second position closer tostationary handle 16 to effect movement of the jaw 8 b toward the jaw 8a from an open (unclamped) position to a clamping position, alsoreferred to as a closed position of the jaws 8. Release of handle lever14 returns the jaw 8 b to its open position. Stationary handle 16 forgrasping by the user is ergonomically designed for comfort of use. Insummary, the surgical stapler operates by manual pivoting of the lever14 toward stationary handle 16 to clamp the tissue between jaws 8,followed by powered firing of the staples from jaw 8 b, through theclamped tissue and into contact with the staple forming pockets of theanvil of jaw 8 b. Prior to firing, the jaws 8 can be rotated to adesired orientation by rotation of endoscopic portion 6 via knob 12and/or articulated about joint 10, via movement of the elongatedarticulation members, to a desired angled position with respect to thelongitudinal axis of endoscopic portion 6. In the embodiment of FIG. 1,articulation is performed by manual manipulation of a lever (not shown)which is operatively connected to an internal elongated member withintubular member 6 which extends to joint 10. A force applied to theinternal elongated member pivots/articulates the jaws 8 about the joint10. In later described embodiments (FIG. 14A), powered articulation isprovided.

The housing 4 of the handle assembly 2 of the surgical stapler isconfigured to receive the loadable/removable power pack 18 in areceptacle (compartment) 20 as shown in FIGS. 3A and 3D. The receptacleincludes a base 25 a and side walls 25 b and 25 c having one or moreguides 23 that cooperate with corresponding guiding structures 28 on theouter wall of the housing 19 of power pack 18 for proper alignment ofthe power pack 18 in the handle assembly 2 during insertion into thereceptacle 20. In the embodiment of FIG. 3A, the guides 28 on power packhousing 19 are in the form of a pair of ribs or projections 28 extendingtransversely to a longitudinal axis of the power pack 18 for receiptwithin grooves formed between guides, e.g., ribs or projections, 23 ofthe compartment 20, also extending transversely with respect to alongitudinal axis of the stapler 1. In the illustrated embodiment, theribs 23 are on opposing sides of the power pack 18 and are axiallyoffset from each other, although in alternate embodiments they can beaxially aligned. Additionally, a different number of ribs (axially ornon-axially aligned) can be provided (with corresponding receivingstructure in the compartment 20). It should be appreciated thatalternatively, the grooves could be provided on the power pack 18 andthe ribs provided in the compartment 20 to provide the guiding structurefor the power pack 18. The guiding structure also helps to retain powerpack 18 in position within the compartment 20. The power pack 18 hasfront and rear concave regions 19 a, 19 b to reduce its overall size.

The handle assembly 2 includes a cover 22 for opening and closing thereceptacle 20. The compartment cover 22 is shown as being hingedlyattached to the housing 4, but may alternatively be fully removable orattached in some other manner such as a slidable connection or the like.The cover 22 is shown pivotable mounted to a top portion of the housing4 (in the orientation of FIG. 2A) for top loading of the power pack,although alternatively, side or bottom loading can be provided. Thecover 22 is shown pivotable from a closed position of FIG. 2A to an openposition of FIG. 3A to enable loading of power pack into the compartment20 of the housing 4. In some embodiments, the cover 20 is spring loadedto an open position so it remains open for loading of the power pack 18.Once loaded, the cover 22 is pivoted about hinge 22 a to its closedposition. A latch can be provided to latch the cover 22 to the housing 4in the closed position. When the cover 22 is in an open position, e.g.,as shown in FIG. 3A, the power pack 18 may be removed from thereceptacle 20 or inserted into the receptacle 20.

When the cover 22 is in a closed position, the seal of the cover 22 isin contact with the rim of the housing 2 such that the receptacle 20,and the power pack 18 if inserted into the receptacle 20, is sealed fromthe environment exterior to the surgical stapler. The top seal 24 can beattached to the cover 22 and in some embodiments can be in the form ofan elastomer that is compressed by the housing, e.g., tightly fitsslightly within the housing or is pressed on the rim of the housing 2.In other embodiments, the elastomer seal 24 can be on the housing 2,i.e., extending around the perimeter of the rim of the compartment 20,and is compressed by the cover 22 to seal between the cover 22 andhousing 4. Other seals can also be provided within the surgical staplerto seal/protect the power pack 18 from contaminants, e.g., body fluids.These seals are discussed in more detail below.

Turning now to the power pack of the present disclosure, and withreference to FIGS. 4A-4I, the power pack 18 includes a motor assembly,battery and electronics contained within housing 19. More specifically,as shown in FIGS. 4A-4E, the power pack 18 includes a powering assemblyincluding a motor 32 connected to a planetary gear box 34 configured togear down the output of the motor 32 for proper drive speeds for firingstaples from jaw 8 b through the tissue into contact with the anvil ofjaw 8 a. The planetary gear box 34 drives a lead screw 36 through one ormore gears operatively connected to the motor shaft. More specifically,upon rotation of the motor shaft by motor 32 in a first direction, gear38 is rotated in the same first direction, causing rotation of the gear30 in a second opposite direction due to the intermeshed teeth of gears30 and 38. Lead screw 36 is operatively connected to gear 30 so thatrotation of gear 30 causes rotation of lead screw 30 in the samedirection. The power pack 18 includes a battery 33 which can berechargeable outside the stapler when the power pack 18 is removed. Thepower pack 18 in some embodiments can include a power switch which isactivated, i.e., turned on, by the clinician to start the motor andeffect staple firing. In other embodiments, the motor can automaticallyturn on when the power pack is fully loaded or upon actuation of anothercontrol on the stapler housing 4. In some embodiments, the motor canautomatically turn off when the power pack is removed from the staplerhousing.

Connected to the end of lead screw 36 (the end opposite the connectionto the gear 30) is a drive mechanism 40. The drive mechanism 40 isconfigured to move in a linear motion (in an axial direction) along thelead screw 36 in response to rotation of the lead screw 36. For example,the drive mechanism 40 may include internal threads that engage externalthreads of the lead screw 36 and may include slides engaged in a trackthat prevent the drive mechanism 40 from rotating and therefore causethe drive mechanism 40 to move linearly (axially) in response torotation of the lead screw 36. As depicted in FIGS. 4A-4G, the powerpack 18 has a compact configuration as the lead screw 36 extendsalongside, slightly spaced from, the motor 32 and gear box 34, i.e.,both the motor 32/gear box 34 and lead screw 36 extending longitudinallywith the lead screw 36 parallel to the motor 32. The drive mechanism 40is connected to a proximal end of lead screw 36 and extends proximallyof the proximal end of the motor 32 in the illustrated embodiment.

The power pack 18 can have features/structure to constrain the motor 32.In the embodiment of FIG. 4F, such feature is in the form of proximalrails 27 a and distal rails 27 b spaced apart axially within the housing19. Motor 32 is seated within proximal rails 27 a and gear box 34 isseated within rails 27 b, the rails 27 a, 27 b retaining the motor andpreventing axial and rotational movement within the housing 19. Bearingor bushings 27 c and 27 d can also be provided to constrain the leadscrew 36 at opposing ends, while allowing rotation thereof, thereby alsoconstraining the motor. Other features can additionally or alternativelybe provided to restrain the motor from axial movement while allowingrotation of the lead screw.

The drive mechanism 40 includes a first output flag or yoke 42, which isdiscussed in more detail below, configured to engage a staple firingmechanism, e.g., firing rod 46, extending longitudinally within thehandle 4. The staple firing rod 46 is operatively connected to a firingrod in the endoscopic portion 6 which is operatively engageable with aseries of staple drivers in jaw 8 b to advance the fasteners (staples)from the fastener jaw 8 b. Alternatively, the firing rod 46 can extendthrough the endoscopic portion 6 and itself engage the stapler driversas shown in FIG. 7C. Thus, as the motor 32 generates rotational motionof the lead screw 36 through the planetary gear box 34 and the gears 38,30, the drive mechanism 40 moves in linear motion along the lead screw36. Such linear motion effects linear movement of the firing rod 46 (dueto the engagement by the flag 42) which advances the staple drivingmechanism to advance (fire) the staples out from jaw 8 b through tissueand into contact with the anvil in jaw 8 a. As noted above, the firingrod 46 can be a single element extending through the endoscopic portion6 (see e.g., FIG. 7C) and terminating adjacent jaws 8 or alternativelycan be attached to one or more components intermediate the firing rod 46and jaws 8. In FIG. 7C, camming surface 46 a of firing rod 46 engagesstaple drivers 47 to sequentially fire staples 51 as the firing rod 46is advanced.

The power pack 18 can also include in some embodiments one or moresensors to indicate the position of the firing rod 46 to indicate to theclinician the status of staple firing. The embodiment of FIG. 4Fillustrates an example of such sensors if they are provided. The powerpack 18 has within the housing a proximal sensor 39 a and a distalsensor 39 b to sense the position of yoke 42 of the drive mechanism 40.Thus, sensor 39 a senses the initial position of the yoke 42 (and thusthe initial position of the firing rod 46) and at the end of the firingstroke, sensor 39 b would indicate the end (final) position of the yoke42 (and thus the final positon of the firing rod 46) which wouldindicate completed firing of the fasteners. The power pack 18 could alsoinclude an audible or visual indicator (viewable though the power packhousing 19 and instrument handle housing 4) actuated by the sensor toindicate to the clinician the position of the flag 42 and thus thecompletion or status of the firing stroke to fire the fasteners. Thepower pack 19 can also include sensors to detect the position of thearticulation flag in the embodiments discussed below which have poweredarticulation. The sensor can include a potentiometer to determine thelocation during the firing stroke. It can also include an encoder todetect the position along the stroke. Alternatively, the stroke can alsobe identified by motor count. The power pack 18 in all other respects isidentical to power pack 18 of FIG. 3A.

It is also contemplated that in alternate embodiments, the sensor(s) canbe carried by the handle housing rather than (or in addition to) thepower pack and utilized to detect the positioning of the flag 42 and/orfiring rod 46 and/or detect the position of the articulation flag and/orarticulation rod in the embodiments discussed below which have poweredarticulation.

It is also contemplated that a sensor(s) can be provided to detect theposition of the clamping rod for clamping the jaws. The sensor can beprovided in (or supported by) the power pack or alternatively thesensor(s) can be carried by the handle housing rather than (or inaddition to) the power pack and utilized to detect the positioning ofthe jaws by detecting the position of the flag engaging the jaw clampingrod and/or detecting the position of the jaw clamping rod in theembodiments which have powered clamping.

Note the sensor can be provided in some embodiments; in otherembodiments, no sensor is provided.

Turning now to the loading of the power pack 18 into the surgicalstapler 1, as seen in FIGS. 6A-6D, the power pack 18 is in the processof being inserted into the receptacle 20 of housing 4. As shown, handlecompartment cover 22 is open to provide access to compartment 20. Theoutput flag 42 of the power pack 18 as noted above is driven by themotor assembly and is configured to engage and interact with structurewithin the handle assembly 2, e.g., firing rod 46, to control operationof the surgical stapler 1 when the power pack 18 is fully inserted intothe receptacle 20. As can be appreciated in FIG. 6D, the output flag 42is not fully engaged with the flange 44 of the firing rod 46. Also shownin FIG. 6D is the clamp bar 49 which is positioned within and concentricwith firing rod 46. The clamp bar 49 is operatively connected to thepivotable handle 14 of stapler 1 via linkage 14 a (pin 14 b connects oneend of handle 14 to the distal end of clamp bar 49). In this manner,movement of pivotable handle 14 toward stationary handle 16 causes theoperatively connected jaw clamping mechanism, e.g., clamp rod 49, to beadvanced distally to pivot jaw 8 b toward jaw 8 a to clamp tissuebetween the two jaws 8. Note that for clamping, clamp bar 49 slideslinearly within a lumen of firing rod 46; for staple firing, firing rod46 moves linearly over clamp bar 49.

The output flag 42 of power pack 18 is configured to engage a bossed end44 of the firing rod 46 when the power pack 18 is fully inserted intothe receptacle 20 of the handle assembly 2. As shown, the output flag(yoke) 42 has a receiving or mounting feature or member (also referredto as the engagement feature (member) or firing rod engagement feature(member) in the form of two arms 43 a and a slot 43 b therebetween,configured to frictionally (and releasably) engage the bossed end 44,the feature aligning with the bossed end 44 during insertion. (Theaforedescribed guiding structure on the power pack 18 and internal wallof the compartment 20 aid such alignment).

FIGS. 8A, 8B and 10 show the power pack 18 fully inserted into thecompartment 20 of stapler 1. In this position, the output flag 42 isengaged with the bossed end 44 of the firing rod 46. Note the firing rod46 is able to rotate when the first output flag 42 of the power pack 18is engaged with the bossed end 44. When the power pack 18 is secured tothe firing rod 46 by the first output flag 42, linear motion generatedat the first output flag 42 by the motor actuated drive assembly istransferred to the firing rod 46, which moves linearly to actuate thestaple firing mechanism. That is, rotation of the gear 30 effects axial(linear) movement of the drive screw 36 which effects axial (linear)movement of the connected drive mechanism 40 to effect axial (linear)movement of the associated drive mechanism (rod) engaging member (i.e.,flag 42). It should be appreciated that flag 42 provides one example ofthe releasable attachment (engagement member) of the motor assembly tothe firing rod 46, it being understood that other mounting (engagement)members or features are also contemplated to engage the firing rod toadvance it axially.

In use, the cover 22 of stapler 1 is opened and the power pack 18 isinserted into receptacle 20 of sterile handle assembly 2 (of sterilestapler 1), with the output flag 42 of the power pack 18 engaging acorresponding feature, e.g., boss 44 of elongated drive rod 46, in thehandle assembly 2 as discussed above. Then, the cover 22 is closed toseal the power pack 18 within the receptacle 20 from the externalenvironment and the surgical stapler 1 may be actuated, i.e., manuallyclamped, articulated and/or rotated if desired, and the motor actuatedto effect staple firing. After applications of fasteners and release(unclamping of the jaws from tissue), the cover 22 can be opened and thepower pack 18 removed and charged while the stapler and handle assemblyare resterilized if the stapler is a reusable instrument or the staplerand handle assembly are disposed of if the stapler is a single usedisposable instrument. The power pack 18, due to its sealedconfiguration discussed above, can be reused without requiringsterilization by insertion into the receptacle 20 of a resterilizedhandle assembly or a sterile handle assembly of an unused disposablehandle assembly. Thus, as can be appreciated, the removable power pack18 does not need to be subjected to the sterilization process and,therefore, contact between the harsh temperatures and/or chemicals ofthe sterilization process is advantageously avoided. Also, by being ableto reuse the power pack without sterilization, significant cost savingsare achieved compared to if the power pack is not resterilizable, isdisposed of along with the disposable stapler.

Note that in the embodiment of FIGS. 1-12 (and FIGS. 14-23B discussedbelow), rotational motion caused by the motor is translated into linearmotion. This is shown schematically in FIG. 5A wherein the drive rod inthe handle housing is engaged by the motor driven drive assembly of thepower pack 18 (or power pack 90 which is discussed below) moves linearly(axially) to effect linear (axial) movement of the drive member in thestapler, e.g., extending through the endoscopic portion, which effectsstaple firing. Alternatively, or in addition, a drive assembly of thepower pack engages a drive rod in the housing which moves linearly toeffect linear movement of a drive rod to effect clamping of the jawsand/or a drive assembly of the power pack engages a drive rod in thehousing which moves linearly to effect linear movement of a drive memberto effect articulation of the jaw assembly. Alternatively, theintermediate drive member could be omitted and the drive rods directlyeffect respective clamping and articulation.

In an alternate embodiment, shown schematically in FIG. 5B, linearmotion is converted back to rotational movement. That is, the handlehousing has a receptacle (compartment) to receive power pack 18 (orpower pack 90) which has one or more engagement features to engage orcouple to a firing rod for firing staples, a clamping rod for clampingthe jaws about tissue and/or an articulation rod to articulate the jawsto angular positions with respect to the longitudinal axis. The driverod is connected at its distal end to a block in the stapler having afemale thread or a slotted guide engagement to prevent rotation of theblock and enable linear movement. (The drive rod could alternatively beattached to other structure). The block is connected to a male leadscrew which is engaged at its proximal end via threaded engagement tothe distal end of the block. The lead screw is connected at its distalend to a component that requires rotation to effect operation of thestapler, such as effecting staple firing, clamping and/or articulation.A bearing can be provided to keep the lead screw on center and controlaxial motion. In use, actuation of the motor advances the drive assemblyof the power pack linearly which is engaged with and advances the driverod in the handle housing linearly (axially). Linear movement of thedrive rod causes linear movement of the block positioned in theendoscopic portion (or alternatively positioned in the handle housing.)Linear movement of the block causes rotation of the male lead screw toengage a staple firing component(s) to effect staple firing.Alternatively, or in addition, the drive assembly, or a separate driveassembly (assemblies), engages a drive rod in the housing which moveslinearly to effect linear movement of a block to cause rotation of thelead screw to move a jaw clamping component(s) to effect clamping of thejaws and/or engages a drive rod in the housing which moves linearly toeffect linear movement of a block to cause rotation of the lead screw tomove an articulation component(s) to effect articulation of the jaws.

In the embodiment of FIGS. 1-12, the power pack 18 actuates the firingrod 46 to fire the staples while other steps are performed manually. Insummary, in this embodiment, in use, the jaws 8 a, 8 b are moved to theclosed (clamped) position manually by a hand actuated lever or control.Also, in this embodiment, the jaws 8 are articulated with respect to thelongitudinal axis of the endoscopic portion manually by a hand actuatedlever or control. Thus, the clinician would manually clamp the jaws,manually rotate the endoscopic portion and attached jaws 8, and manuallyarticulate the jaws by manipulation of controls at the proximal end ofthe stapler 1, e.g., at the handle 4.

FIGS. 1-12 show one embodiment of an endoscopic linear stapler that canbe used with the power pack 19 of the present disclosure. However, thepower pack 18 is not limited to such endoscopic staplers. For example,FIGS. 13A and 13B illustrate another endoscopic linear stapler,designated by reference numeral 100, that can be powered by power pack18. Stapler 100 has a handle 102 manually pivotable towards stationaryhandle 103 for clamping of the jaws 108 a, 108 b, an endoscopic portion106 extending from the handle housing 101, a jaw assembly 104 containingjaws 108 a, 108 b and connector 107 a extending proximally from shaft ortube 107 for attachment to the endoscopic portion 106 so that the jawassembly 104 can be replaced multiple times in a single surgicalprocedure to provide additional rows of staples to tissue. The stapler100 also includes a rotation knob 109 for rotation of the endoscopicportion 106, with respect to the handle housing, to rotate the attachedjaws 108 a, 108 b. The stapler 100 can also include an articulation knobto articulate the jaws. Power pack 18 is shown in FIG. 13A prior toloading within the handle housing 101 and shown in FIG. 13B fully loaded(inserted) within the handle housing 101. A cover (not shown) can beprovided to seal the power pack 18 from the external environment. As inthe embodiment of FIGS. 1-12, the flag 42 extending from lead screw 36engages a firing rod within the handle housing 101 to effect movement ofa firing rod to fire the staples when the motor of the power pack 18 isactuated. Power pack 90 having articulation described below can also beutilized with stapler 100.

FIGS. 13C and 13D illustrate another endoscopic linear stapler that canreceive the power pack 18. Endoscopic linear stapler 110 has a handle112 manually pivotable toward stationary handle 113 for clamping of thejaws 118 a, 118 b, an endoscopic portion 116 extending from the handlehousing 111, and a jaw assembly at the distal end of the endoscopicportion 116. The stapler 110 also includes a rotation knob 119 forrotation of the endoscopic portion 116 to rotate the jaws 118 a, 118 b.The stapler 110 can also include an articulation knob to articulate thejaws 118 a, 118 b. Power pack 18 is shown in FIG. 13C prior to loadingwithin the handle housing 112 and shown in FIG. 13D fully loaded(inserted) within the handle housing 112. A cover (not shown) can beprovided to seal the power pack 18 from the external environment. As inthe embodiment of FIGS. 1-12, the flag 42 extending from lead screw 36engages a firing rod within the handle housing 111 to effect movement ofa firing rod to fire the staples when the motor of the power pack 18 isactuated. Power pack 90 having articulation described below can also beutilized with stapler 110.

FIGS. 30A-30D illustrate another type of endoscopic linear stapler thatcan receive and be powered by the power pack 18. Stapler 260 has ahandle 266 manually pivotable towards stationary handle 264 for clampingof the jaws, an endoscopic portion 268 extending from the handle housing267, and a jaw assembly containing jaws 272 a, 272 b. The endoscopicportion 268 is flexible which enables use in various endoscopicprocedures. The stapler 260 also includes a rotation knob 270 forrotation of the endoscopic portion 268 to rotate the jaws 272 a, 272 b.Power pack 18 is shown fully loaded (inserted) within the handle housing262 and cover 263 closed to seal the power pack 18 from the externalenvironment. As in the embodiment of FIGS. 1-12, the flag 42 extendingfrom lead screw 36 engages a firing rod within the handle housing 262 toeffect movement of a flexible firing rod extending through flexibleendoscopic portion 268 to fire the staples when the motor of the powerpack 18 is actuated. Power pack 90 having articulation described belowcan also be utilized with stapler 260.

The power pack 18 is also not limited to use with endoscopic linearstaplers, nor is it limited to use with staplers. FIGS. 28A-29Dillustrate two examples of different staplers. As in the endoscopiclinear staplers discussed herein, these staplers can also have a knifebar to cut tissue between the rows of staples applied to the tissue.

By way of example, the power pack 18 can be used with a circular staplerthat applies circular arrays of staples such as shown in FIGS. 28A-28D.Surgical stapling instrument 220 can receive and be powered by the powerpack 18 of the present disclosure. Stapler 220 has a handle 226 manuallypivotable towards stationary handle 264 for clamping of the jaws, anelongated tubular portion 228 extending from the handle housing 222, anda jaw assembly having an anvil (jaw) 232 and a cartridge (jaw) 235containing circular arrays of fasteners (staples). The anvil 232 has aproximal clamping surface 233 and is movable by anvil rod 234 toward thecartridge 235 to clamp tissue between the anvil clamping surface 233 anddistal clamping surface 236 of cartridge 235 by manual movement ofhandle 226 toward stationary handle 224. The stapler 220 also includes arotation knob 230 for rotation of the elongated portion (shaft) 228 torotate the jaws 232, 235. Power pack 18 is shown fully loaded (inserted)within the handle housing 222 and cover 223 is shown closed to seal thepower pack 18 from the external environment. As in the embodiment ofFIGS. 1-12, the flag 42 extending from lead screw 36 engages a firingrod within the handle housing 222 to effect movement of a firing rodextending through elongated portion 228 to fire the circular arrays ofstaples when the motor of the power pack 18 is actuated. Power pack 90having articulation described below can also be utilized with stapler220.

By way of another example, the power pack can be used with a linearstapler that applies transverse rows of staples in a linear direction,i.e., parallel to the longitudinal axis of the stapler, such as shown inFIGS. 29A-29D. Surgical stapling instrument 240 can receive and bepowered by the power pack 18 of the present disclosure. Stapler 240 hasa handle 246 manually pivotable towards stationary handle 244 forclamping of the jaws, an elongated tubular portion 248 extending fromthe handle housing 242, and a jaw assembly containing an anvil (jaw) 252and a cartridge (jaw) 255 containing linear rows of fasteners (staples)arranged perpendicular to the longitudinal axis of the stapler 240. Theproximal anvil clamping surface 253 of anvil 252 and distal clampingsurface 256 of cartridge 255 are brought into approximation by manualmovement of handle 246 toward stationary handle 244 which advancescartridge 255 toward anvil 252. (Alternatively the anvil could beretracted toward the cartridge) The stapler 240 also includes a rotationknob 250 for rotation of the elongated portion (shaft) 248 to rotate theelongated portion 248 and jaws 252, 255. Power pack 18 is shown fullyloaded (inserted) within the handle housing 242 and cover 243 is shownclosed to seal the power pack 18 from the external environment. As inthe embodiment of FIGS. 1-12, the flag 42 extending from lead screw 36engages a firing rod within the handle housing 242 to effect movement ofa firing rod extending through elongated portion 248 to fire the staplesfrom cartridge 255 when the motor of the power pack 18 is actuated.Power pack 90 having articulation described below can also be utilizedwith stapler 240.

The power pack 18 can also be used with single firing instruments thatfire a single staple, clip, tack, etc. into body tissue. Two examples ofsuch instruments are illustrated in FIGS. 31A-31D and FIGS. 34A-34D.Turning first to the instrument 280 of FIGS. 31A-31D, by way of example,surgical clip applying instrument 280 can receive and be powered by thepower pack 18 of the present disclosure. Stapler 280 has a handle 286manually pivotable towards stationary handle 284 for loading a clip intothe jaws, an elongated tubular portion 288 extending from the handlehousing 282, and a pair of pivotable jaws 292 which support a cliptherebetween. Closing of the jaws 292 crimps the clip about tissue. Theclip applier 280 also includes a rotation knob 290 for rotation of theelongated portion (shaft) 288 to rotate the jaws 292. Power pack 18 isshown fully loaded (inserted) within the handle housing 282 and cover283 is shown closed to seal the power pack 18 from the externalenvironment. As in the embodiment of FIGS. 1-12, the flag 42 extendingfrom lead screw 36 engages a rod within the handle housing 282 operablyconnected to a clip closing mechanism to effect movement of the clipclosing mechanism to close the jaws to apply to tissue a surgical clipsupported by the jaws 292. The power pack 18 can also have a motorpowered drive assembly for advancing the clip into the jaws 292, thedrive assembly engageable with a clip feed mechanism.

Another example of a single firing instrument is illustrated in FIGS.34A-34D and designated generally by reference numeral 340. Instrument340 can receive and be powered by the power pack 18 of the presentdisclosure. Instrument 340 has a handle 346 manually pivotable towardsstationary handle 344 for angling the surgical tack and an elongatedtubular portion 348 extending from the handle housing 342. Tackersupport 345 is pivotable relative to the longitudinal axis by movementof handle 346 which is operably connected to an elongated member whichpivots support 345. The instrument 340 also includes a rotation knob 350for rotation of the elongated portion (shaft) 348. Power pack 18 isshown fully loaded (inserted) within the handle housing 342 and cover343 is shown closed to seal the power pack 18 from the externalenvironment. As in the embodiment of FIGS. 1-12, the flag 42 extendingfrom lead screw 36 engages a rod within the handle housing 342 operablyconnected to a tack firing mechanism to effect advancement of the tack347 into tissue. The power pack 18 can also be provided with a motorpowered drive assembly to pivot support 345.

In the embodiments of FIGS. 1-12, a gear mechanism is driven by themotor to rotate the lead screw to advance the drive mechanism to effectfiring of the staples. In the alternate embodiments of FIGS. 24A-27D, abelt drive mechanism is used to effect firing. The belt drive mechanismis contained in the power pack 18 in the same manner as the gearmechanism of the foregoing embodiments, and thus the power pack for thebelt drive would include the housing 19 of the configuration of FIG. 1and loaded in the stapler 1 in the same manner as power pack 18described above. The belt drives of FIGS. 24A-27D are described belowfor use with stapler 1 of FIG. 1 A but can be used in the other surgicalstaplers and instruments disclosed wherein which are designed to receivepower pack 18 or power pack 90 for powered actuation.

Turning first to the embodiment of FIGS. 24A-24D, the belt driveassembly (mechanism) includes a motor 148 connected to a planetary gearbox 150 configured to gear down the output of the motor 148 for properdrive speeds for firing staples from jaw 8 a through the tissue intocontact with the anvil of jaw 8 b. The planetary gear box 150 drives alead screw 144 via the drive belt operatively connected to the motorshaft. More specifically, upon rotation of the motor shaft by motor 148,first rotatable disc 152 (also referred to as the first wheel or pulley)is rotated in a first direction, causing movement of belt 156 androtation of second rotatable disc 154 (also referred to as the secondwheel or pulley). Note the two discs 152, 15 are spaced apart and not incontact. Lead screw 144 is operatively connected to disc 154 so thatrotation of disc 154 causes rotation of lead screw 144 in the samedirection. The power pack 18 includes a battery which can berechargeable outside the stapler when the power pack 18 is removed. Themotor 148 is actuated in the various ways described above with regard topower pack 18 of FIG. 3A. A tensioner can be provided such as tensioner158, illustratively in the form of a tension disc or wheel, to apply aforce against the belt 156. In the orientation of FIGS. 24C and 24D, thetensioner 158 is positioned underneath the drive belt 156 and applies anupward tensioning force against the belt 156 in a direction toward discs152, 154. Other types of mechanisms to apply a tensioning force to thebelt are also contemplated for use in the embodiments of FIGS. 24A-27Dif such tensioning of the drive belt 156 is desired.

Connected to the end of lead screw 144 (the end opposite of theconnection to the disc 154) is a drive mechanism 142. The drivemechanism 142, like drive mechanism 40 of FIG. 3A, is configured to movein a linear motion (in an axial direction) along the lead screw 144 inresponse to rotation of the lead screw 144. For example, as in the drivemechanism 40, drive mechanism 142 may include internal threads thatengage external threads of the lead screw 144 and may include slidesengaged in a track that prevent the drive mechanism 142 from rotatingand therefore cause the drive mechanism 142 to move linearly in responseto rotation of the lead screw 144. As shown, the lead screw 144 extendsalongside, slightly spaced from, the motor 148 and gear box 150, i.e.,both the motor 148/gear box 150 and lead screw 144 extendinglongitudinally with the lead screw 144 parallel to the motor 148. Thedrive mechanism 142 extends proximally of the proximal end of the motor148 in the illustrated embodiment.

The drive mechanism 142, like drive mechanism 140 of FIG. 3A, includes afirst output flag or yoke 146 with slot 143 configured to engage astaple firing rod 46 extending longitudinally within the handle 4. Theflag 146 is the same as flag 42 of FIG. 4A and engages the staple firingrod 46 in the same manner as flag 42. Therefore, for brevity, furtherdiscussion of flag 146 and it engagement with firing rod 46 is notprovided as the structure and function of flag 42, and alternativefiring rod engagement features, are fully applicable to flag 146 ofFIGS. 24A-24D. In brief, as the motor 148 generates rotational motion ofthe lead screw 144 through the drive belt, the drive mechanism 144 movesin linear motion along the lead screw 144 to effect linear movement ofthe firing rod 46 which advances the staple driving mechanism to advance(fire) the staples out from jaw 8 b through tissue and into contact withthe anvil in jaw 8 a.

FIGS. 25A-25D illustrate an alternate embodiment of a belt drivemechanism. Belt drive mechanism (assembly) 160 is identical to beltdrive 140 except for the different sized discs (wheels). That is,assembly 160 has a motor 168 connected to a planetary gear box 170configured to gear down the output of the motor 168. The planetary gearbox 170 drives a lead screw 164 through the belt drive operativelyconnected to the motor shaft. Upon rotation of the motor shaft by motor168, first disc 172 is rotated in a first direction, causing movement ofbelt 176 and rotation of second disc 174 in the same direction. Leadscrew 164 is operatively connected to disc 174 so that rotation of disc174 causes rotation of lead screw 164 in the same direction. A tensioner178 like tensioner 158 can be provided to apply tension to the belt 176.The drive mechanism 162, like drive mechanism 40 of FIG. 3A, includes afirst output flag or yoke 166 with slot 163 configured to engage astaple firing rod 46 in the same manner as flag 42. Rotation of themotor shaft generates rotational motion of the lead screw 164 throughthe drive belt, causing the drive mechanism 162 to move in linear motionalong the lead screw 164 to effect linear movement of the firing rod 46which advances the staple driving mechanism to advance (fire) thestaples out from jaw 8 b through tissue and into contact with the anvilin jaw 8 a.

The belt drive 160 differs from belt drive 140 of FIG. 24A in thatsecond disc 174 which is operatively connected to lead screw 164 islarger in diameter than first disc 172. Consequently, instead ofproviding a one to one ratio of the discs as in discs 154 and 152 ofFIG. 24A, a greater ratio of disc 174 to disc 172 is provided whichvaries the output of motor 168. That is, the rotational output of leadscrew 164 is less than the rotational output of the motor shaft due tothe differing degree of rotation of discs 174, 178 due to the varyingsizes. In all other respects, mechanism 160 is identical to mechanism140.

FIGS. 26A-26D illustrate an alternate embodiment of a belt drivemechanism. Belt drive mechanism (assembly) 180 is identical to beltdrive 140 of FIG. 24A except for the configuration of the drive belt anddiscs. That is, assembly 180 has a motor 188 connected to a planetarygear box 190 configured to gear down the output of the motor 188. Theplanetary gear box 190 drives a lead screw 184 through the belt driveoperatively connected to the motor shaft. Upon rotation of the motorshaft by motor 188, first disc (wheel or pulley) 192 is rotated in afirst direction, causing movement of belt 196 and rotation of seconddisc (wheel or pulley) 194. Lead screw 184 is operatively connected todisc 194 so that rotation of disc 194 causes rotation of lead screw 184in the same direction. A tensioner 198 like tensioner 158 can beprovided to apply tension to the belt 196. The drive mechanism 182, likedrive mechanism 140 of FIG. 3A, includes a first output flag or yoke 186with slot 183 configured to engage a staple firing rod 46 in the samemanner as flag 42. Rotation of the motor shaft generates rotationalmotion of the lead screw 184 through the drive belt, causing the drivemechanism 182 to move in linear motion along the lead screw 184 toeffect linear movement of the firing rod 46 which advances the stapledriving mechanism to advance (fire) the staples out from jaw 8 b throughtissue and into contact with the anvil in jaw 8 a.

The belt drive 180 differs from belt drive 140 of FIG. 24A in that discs192, 194 have teeth to engage ribs or treads on belt 196. As shown, thetoothed discs 192, 194 are spaced apart so their teeth/projections donot intermesh—the teeth of disc 192 engage belt 196 and the teeth ofdisc 194 engage belt 196. Rotation of disc 192 moves drive belt 194 inthe same direction due to its engagement with the teeth, which causesrotation of toothed disc 194 in the same direction due to engagementwith its teeth to rotate lead screw 184. In all other respects,mechanism 180 is identical to mechanism 140.

FIGS. 27A-27D illustrate an alternate embodiment of a belt drivemechanism. Belt drive mechanism (assembly) 200 is identical to beltdrive 180 except for the different sized discs. That is, assembly 200has a motor 208 connected to a planetary gear box 210 configured to geardown the output of the motor 208. The planetary gear box 210 drives alead screw 204 through the belt drive operatively connected to the motorshaft. Upon rotation of the motor shaft by motor 208, first disc (wheelor pulley) 212 is rotated in a first direction, causing movement of belt216 and rotation of second disc (wheel or pulley) 214. Lead screw 204 isoperatively connected to disc 214 so that rotation of disc 214 causesrotation of lead screw 204 in the same direction. A tensioner 218 liketensioner 198 can be provided to apply tension to the belt 216. Thedrive mechanism 202, like drive mechanism 140 of FIG. 3A, includes afirst output flag or yoke 206 with slot 203 configured to engage astaple firing rod 46 in the same manner as flag 42. Rotation of themotor shaft generates rotational motion of the lead screw 204 throughthe drive belt, causing the drive mechanism 202 to move in linear motionalong the lead screw 204 to effect linear movement of the firing rod 46which advances the staple driving mechanism to advance (fire) thestaples out from jaw 8 b through tissue and into contact with the anvilin jaw 8 a.

The belt drive 200 differs from belt drive 180 of FIG. 24A in thatsecond toothed disc 214 which is operatively connected to lead screw 204is larger in diameter than first toothed disc 172. Consequently, insteadof providing a one to one ratio of the discs as in discs 194 and 192, agreater ratio of disc 214 to disc 212 is provided which varies theoutput of motor 208. That is, the rotational output of lead screw 204 isless than the rotational output of the motor shaft due to the differingdegree of rotation of discs 214, 212 due to the varying sizes. In allother respects, mechanism 200 is identical to mechanism 180.

It should be appreciated that the foregoing belt drive mechanisms can beused as an alternative to the gear mechanism in power pack 18 as well asan alternative to one or both of the gear mechanisms of power pack 90discussed below.

In the foregoing embodiments, the power pack 18 was described forpowering staple firing. In an alternate embodiment, the power pack caninclude a drive mechanism for effecting articulation. This motor poweredarticulation can be in addition to the motor powered staple firing, oralternatively, the power pack can be used solely for poweredarticulation. The embodiment of FIGS. 14A-23B illustrate a surgicalstapler and power pack which powers both staple firing and articulation.If only for articulation, the power pack described below (power pack 90)would not include the gear mechanism engageable with the firing rod 46for staple firing.

With initial reference to FIGS. 14A-14C, surgical stapler 61 isidentical to surgical stapler 1 of FIG. 1A except for the power packmounted in the stapler 61 and the articulation rod in the stapler 61which is engaged by the power pack. Thus, like stapler 1, stapler 61 hasa handle assembly 63, an endoscopic portion 66 extending distallytherefrom and a pair of jaws 68 a, 68 b,(collectively “jaws 68”) with atleast one of the jaws movable relative to the other jaw, e.g., jaw 68 bcontaining the staples (fasteners) movable toward stationary jaw 68 acontaining the anvil pockets. Handle 72 like handle 14 of stapler 1 ispivotable toward stationary handle 70 to approximate jaws 68 a, 68 b toclamp tissue between the closed jaws 68 a, 68 b. Handle assembly 63includes a housing 64 and cover 62 which is identical to cover 22 ofstapler 1, i.e., pivotably mounted to the housing 64 to move from aclosed to an open position for top loading (or alternatively otherdirectional loading) a power pack into the compartment within thehousing 64. The compartment, like compartment 25 described above,retains the power pack and can include guiding structure for alignmentof the power pack similar to guiding structure 23 described above toreceive guides 90 a, 90 b of power pack 90. Stapler 61 also includes arotation knob 74 which functions in the same manner as rotation knob 12of stapler 1 described above to rotate tubular portion (shaft) 66. Thejaw assembly, i.e., jaws 68 a, 68 b, articulate about joint 69 to movethe jaws 68 a, 68 b to angular positions with respect to thelongitudinal axis of stapler 61.

The power pack in the embodiment of FIGS. 14A-23B is designated byreference numeral 90 and has a motor assembly and drive mechanism forfiring staples which is identical to that of the power pack 18 of FIG.3A. However, power pack 90 differs from power pack 18 in that itadditionally has a motor assembly and drive mechanism for articulatingthe jaws. The addition of the articulation assembly can be appreciatedby a comparison of the cross-sectional view of FIG. 4H, which onlyeffects firing of the fasteners (staplers), and the cross-sectional viewof FIG. 15F which effects firing of fasteners and articulation of thejaw assembly.

More specifically, with reference to FIGS. 15A-15F and 18B, the poweredstaple firing assembly like the firing assembly of power pack 18 of FIG.4H, includes a motor 83 connected to a planetary gear box 85 configuredto gear down the output of the motor in the same manner as motor 32 andgear box 34 of power pack 18. The planetary gear box 85 drives a leadscrew 86 through one or more gears operatively connected to the motorshaft. More specifically, upon rotation of the motor shaft by the motor83 in a first direction, gear 81 is rotated in the same first direction,causing rotation of the gear 84 in a second opposite direction due tothe intermeshed teeth of gears 81 and 84. Lead screw 86 is operativelyconnected to gear 84 so that rotation of gear 84 causes rotation of leadscrew 86 in the same direction. The power pack 18 includes a battery 33which can be rechargeable outside the stapler when the power pack 18 isremoved. The power pack 90 in some embodiments can include a powerswitch which is activated, i.e., turned on, by the clinician to startthe motor and effect staple firing. In other embodiments, the motor canautomatically turn on when fully loaded or upon actuation of anothercontrol on the stapler housing 4.

Connected to the end of lead screw 86 (the end opposite the connectionto the gear 84) is a drive mechanism 80 which is configured to move in alinear motion (in an axial direction) along the lead screw 86 inresponse to rotation of the lead screw 86. Drive mechanism 80 includes aflag or yoke 82 identical to yoke 42 of power pack 18 discussed above,which engages flange or boss 76 of firing rod 75 within housing 64 ofstapler 61. The connection of the flag 82 to the firing rod 76, themotor and gear mechanism, and the drive mechanism 80 of power pack 90are the same as the power pack 18 and therefore the aforedescribedfunctions and features/components of power pack 18 for staple firing arefully applicable to the function and features/components of power pack90 for staple firing so for brevity are not fully repeated herein. Itshould also be appreciated that the alternative mechanisms for motorpowered stapled firing, such as the various belt drive mechanismsdiscussed above and/or illustrated in the Figures, can also be used inthe power pack 90 to effect staple firing. Additionally, the varioussensors discussed above with regard to sensing the firing stroke canalso be provided in power pack 90 for the same uses.

Power pack 90 also has an articulation assembly, shown in detail inFIGS. 22A-22D. The articulation assembly includes a powering assemblyincluding a motor 96 connected to a planetary gear box 93 configured togear down the output of the motor 96. The planetary gear box 93 drives alead screw 98 through gears 91, 92 operatively connected to the motorshaft. More specifically, upon rotation of the motor shaft by motor 96in a first direction, gear 91 is rotated in the same first direction,causing rotation of the gear 92 in a second opposite direction due tothe intermeshed teeth of gears 92 and 91. Lead screw 98 is operativelyconnected to gear 92 so that rotation of gear 92 causes rotation of leadscrew 98 in the same direction. The power pack 90 in some embodimentscan include a power switch which is activated, i.e., turned on, by theclinician to start the motor and effect articulation.

Connected to the end of lead screw 98 (the end opposite the connectionto the gear 92) is a drive mechanism 95 configured to move in a linearmotion (in an axial direction) along the lead screw 98 in response torotation of the lead screw 98. For example, the drive mechanism 95, likedrive mechanisms 40 and 80 described above, may include internal threadsthat engage external threads of the lead screw 98 and may include slidesengaged in a track that prevent the drive mechanism 95 from rotating andtherefore cause the drive mechanism 95 to move linearly (axially) inresponse to rotation of the lead screw 98. As depicted, the power pack90 has a compact configuration as the lead screw 98 extends alongside,slightly spaced from, the motor 96 and gear box 93, i.e., both the motor96/gear box 93 and lead screw 98 extending longitudinally with the leadscrew 98 parallel to the motor 96. The drive mechanism 95 is connectedto a proximal end of lead screw 98. The drive mechanism 95 has anarticulation rod engagement feature in the form of a flange or yoke 94extending therefrom having legs 99 a and a recess 99 b to engage anarticulation rod 79 within the housing 63. In the illustrated embodiment(see e.g., FIGS. 15B and 22C), the articulation rod 79 includes a flange78 which is engageable by the flag 94. The output flag 94 can engage thebossed end 78 of the articulation tube 79 in substantially the samemanner as the output flag 42 engages the bossed end 44 of the firing rod46 as discussed above.

The articulation assembly of the power pack 90 is oriented in theopposite direction from the staple firing assembly to minimize the spacerequired in the power pack 90, thereby providing the power pack with acompact configuration. As can be appreciated by reference to FIGS. 15Aand 15F, the drive assembly 80 and associated flag 82 are at a proximalend of the assembly for firing staples with the lead screw 86 extendingdistally toward the gears 81, 84. The driving assembly 95 withassociated flag 94 of the assembly for articulation are at a distal endwith the lead screw 98 extending proximally toward gears 91, 92. Also ascan be appreciated by reference to the orientation of FIGS. 15A and 15F,the articulation assembly is above (closer to the cover 22) than thefiring assembly, and the articulation assembly in the illustratedembodiment is positioned axially proximal of gears 81, 84 and axiallydistal of drive mechanism 80, radially spaced from lead screw 86.

The power pack 90, like power pack 18 can have features/structure toconstrain the motors 84 and 96. In the embodiment of FIG. 15D, suchfeature is in the form of proximal rails 97 a and distal rails 97 bspaced apart axially within the housing of the power pack 90. Gear box93 is seated within proximal rails 97 a and motor 96 is seated withindistal rails 97 b, the rails 97 a, 97 b retaining the motor andpreventing axial and rotational movement within the housing of powerpack 90. Bearing or bushings 98 a, 98 b can also be provided toconstrain the lead screw 98 at opposing ends, while allowing rotationthereof, thereby also constraining the motor. Other features canadditionally or alternatively be provided to restrain the motor fromaxial movement while allowing rotation of the lead screw.

The power pack 90 can include guides, e.g., projections 90 a, 90 b,either axially aligned or axially offset, similar to guides 28 of powerpack 18 for alignment with guiding structure in the compartment ofstapler 61.

In use, with the cover 62 of stapler 61 in the open position, power pack90 is loaded into the compartment of the handle housing 63. The cover 62is closed to seal the power pack 90 from contaminants in same manner ascover 22 of stapler 1. Upon loading of the power pack 90, flag 82 of thedrive mechanism 80 of the staple firing assembly engages flange 76 offiring rod 75 and flag 94 of drive mechanism 95 of the articulationassembly engages flange or bossed end 78 of articulation rod 79.Actuation of the motor 96 effects linear motion of the flag 94 whichmoves the articulation rod 79 linearly (axially). The articulation rod79 is either directly coupled to the joint 69, or coupled to anothermember or multiple members which are coupled to the joint 69. When movedlinearly, the articulation rod 79 effects movement of the jaws 68A, 68 bof the stapler 61 to angular positions with respect to the longitudinalaxis of the stapler 61. Note the articulation drive assembly operates ina similar manner as the firing drive assembly of power pack 18 in thatwhen the power pack 90 is secured to the tube 79 by the second outputflag 94, linear motion generated at the second output flag 94 istransferred to linear motion of the tube 79.

Actuation of the motor 83 effects linear motion of the flag 82 whichmoves the firing rod 75 linearly (axially). The firing rod 75 eitherextends through the elongated portion 66 for engagement of the firingmechanism in the jaw 68 b or is coupled to another elongatedcomponent(s) extending through the endoscopic portion 66 to engage thefiring mechanism in the jaw 68 b. Note that the articulation rod or tube79 can be configured to receive the firing rod 75 so that the firing rod75 can move within the tube 79 to effect firing and the articulation rod79 can slide linearly over the firing rod to effect articulation.

After use, the cover 62 can be opened and the power pack 90 removed andcharged while the handle assembly 63 (and stapler 61) is sterilized ordisposed of if the stapler is a disposable instrument. The power pack90, like power pack 18 described above, may be reused without requiringsterilization by being inserted into the receptacle of thenow-sterilized handle assembly 63 or a different sterile handleassembly. Thus, the removable power pack 90, like power pack 18, doesnot need to be subjected to the sterilization process and, therefore,contact between the harsh temperatures and/or chemicals of thesterilization process is advantageously avoided.

One or more seals are utilized for sealing power pack 18 and power pack90 within the handle assembly 2 or 63 so that the power pack remainssterile and is not exposed to bodily fluids during surgical procedures.For example, as discussed above, in the stapler 1 of FIG. 1, the topseal 24 is positioned at the interface between the cover 22 and thehousing 4 of the handle assembly 2 where the cover 22 closes for sealingthe opening into the receptacle 20 and, therefore, power pack 18 fromthe environment when positioned therein. Similarly, in the stapler 61 ofFIG. 14A, the top seal is positioned at the interface between the cover62 and the housing 64 of the handle assembly 63 wherein the cover 62closes for sealing the opening into the receptacle and, therefore, powerpack 90 from the environment when positioned therein. As shown in FIGS.21A-21C, further seals can be provided to further seal the receptacleand thus the power pack. An O-ring 56 is placed around the articulationrod 79 to seal the space around the rod 79. A flexible trigger seal 58surrounds the lever 72 for sealing the internal components of the handleassembly 63 throughout the range of positions of the movable lever 72.Thus, all of the openings into the receptacle of the handle assembly 63are sealed from the external environment. The O-ring seal 56 and triggerseal 58 can also be used in stapler 1 so the openings into thereceptacle 20 of handle assembly 2 are sealed from the externalenvironment. Elastomeric seal 59 a seals cover 62 from U-channel 59within the handle which supports the power pack 90. Additional seals canbe provided to prevent flow of body fluid through the endoscopic portion66 (and endoscopic portion 6). Other types of seals and seals indifferent locations are also contemplated.

As noted above, the power pack 90 can be used with the other staplersdisclosed herein, e.g. circular staplers, linear staplers, as well asother instruments wherein two powered functions are desired. The firstmotor assembly can effect linear motion of a first elongated member toeffect a first function of the stapler, e.g., clamping, articulation,firing, and the second motor assembly can effect linear motion of asecond elongated member to effect a second different function of thestapler, e.g., clamping, articulation, firing. In the embodiment of FIG.14A, one function is articulation and another function is staple firing.Note the power pack 90 can also be used with surgical instruments otherthan surgical staplers such as those illustrated in FIGS. 33A and 34A.

In the foregoing embodiments, use of the power pack of the presentdisclosure to fire staples such as in endoscopic linear staplers, opensurgery linear staplers, circular staplers, as well as firing singleclips or tacks were disclosed as examples. It should be appreciated thatthe power packs of the present disclosure can also be used to powerfunctions of other surgical instruments. FIGS. 33A-34D illustrate twoexamples of such instruments.

In FIGS. 32A-32D an endoscopic scissors, designated generally byreference numeral 300, can receive and be powered by the power pack 18(or power pack 90) of the present disclosure. Scissors 300 has a handle306 manually pivotable towards stationary handle 304 to effect closingof the jaws, an elongated tubular portion 308 extending from the handlehousing 302, and a pair of pivotable jaws 312 with cutting edges.Closing of the jaws 312 severs tissue between the jaws. The scissors 300include a rotation knob 310 for rotation of the elongated portion(shaft) 308 to rotate the jaws 312. Power pack 18 is shown fully loaded(inserted) within the handle housing 302 and cover 303 is shown closedto seal the power pack 18 from the external environment. As in theembodiment of FIGS. 1-12, the flag 42 extending from lead screw 36engages a rod within the handle housing 302 operably connected to a jawclosing mechanism to effect movement of jaws 312 toward each other tosever tissue between the jaws 312. Either one or both jaws 312 can bemovable.

In FIGS. 33A-33D an endoscopic grasper, designated generally byreference numeral 320, can receive and be powered by the power pack 18(or power pack 90) of the present disclosure. Grasper 320 has a handle326 manually pivotable towards stationary handle 324 to effect closingof the jaws 332, an elongated tubular portion 328 extending from thehandle housing 322, and a pair of pivotable jaws 332 with graspingsurfaces that can include teeth, roughened surfaces, ribs, etc. Closingof the jaws 332 grasps tissue between the grasping surfaces of jaws 332.Either one of the jaws can be movable, i.e., pivotable, or both jaws canbe movable (pivotable) toward and away from each other, for movementbetween closed and open positions. The graspers 320 includes a rotationknob 330 for rotation of the elongated portion (shaft) 328 to rotate thejaws 332. Power pack 18 is shown fully loaded (inserted) within thehandle housing 322 and cover 323 is shown closed to seal the power pack18 from the external environment. As in the embodiment of FIGS. 1-12,the flag 42 extending from lead screw 36 engages a rod within the handlehousing 322 operably connected to a jaw closing mechanism to effectmovement of jaws 332 to close the jaws to grasp tissue between the jaws332. It should be appreciated that the aforedescribed variations of thepower packs can also be used with the surgical instruments of FIGS. 32Aand 33A.

The power packs 18 and 90 disclosed herein can be used in surgery wherethe clinician manually clamps the jaws and actuates the motor or motorsto provide powered staple firing and/or powered jaw articulation. It isalso contemplated that the power packs 18 and 90 can be used withrobotic driven surgical staplers wherein clamping, motor actuation andany other functions of the instrument are performed robotically,including remote robotic control.

Although the apparatus and methods of the subject disclosure have beendescribed with respect to preferred embodiments, those skilled in theart will readily appreciate that changes and modifications may be madethereto without departing from the spirit and scope of the presentdisclosure as defined by the appended claims.

1-12. (canceled)
 13. A surgical instrument comprising: a housingcontaining a compartment therein; an elongated member extending distallyfrom the housing; a jaw assembly including a first jaw and a second jawat a distal portion of the elongated member, at least the first jawmovable with respect to the second jaw; a jaw clamping mechanism movablebetween a first position and second position to move at least the firstjaw toward the second jaw to clamp tissue between the first and secondjaws; a firing mechanism movable between a first position and a secondposition to fire fasteners into the tissue clamped between the first andsecond jaws; an articulation mechanism movable between a first positionand a second position to articulate the jaw assembly from a linearposition to a second position angled with respect to a longitudinal axisof the elongated member; a cover on the housing movable from a closedposition to an open position to access the compartment; and a power packloadable into the compartment, the power pack having a motor and anengagement member engageable with the articulation mechanism within thehousing to effect movement of the articulation mechanism from the firstposition to the second position, wherein the power pack engages thearticulation mechanism when loaded into the compartment
 14. The surgicalinstrument of claim 13, further comprising a handle manually movable tomove the jaw clamping mechanism to clamp tissue between the first andsecond jaws. 15-20. (canceled)
 21. The surgical instrument of claim 13,wherein actuation of the motor converts rotary motion to linear motionwithin the power pack to move the engagement member linearly to therebymove the articulation mechanism linearly to the second position.
 22. Thesurgical instrument of claim 13, wherein the housing or the coverincludes a first seal to seal about the cover in a closed position ofthe cover to protect the power pack positioned within the compartment ofthe housing.
 23. The surgical instrument of claim 22, further comprisinga second seal to block passage of body fluids from the elongated memberinto the compartment.
 24. The surgical instrument of claim 13, whereinthe cover is hingedly attached at a distal portion and is pivotable awayfrom the housing in a direction away from the longitudinal axis of thesurgical instrument.
 25. The surgical instrument of claim 13, whereinthe firing mechanism is within the housing and the power pack includes asecond motor and the second motor effects linear movement of the firingmechanism, and actuation of the second motor converts rotary motion tolinear motion within the power pack to move the firing mechanism in thehousing linearly.
 26. The surgical instrument of claim 25, wherein thefiring mechanism fires a plurality of rows of staples from one of thefirst and second jaws into contact with an anvil carried by the other ofthe first and second jaws.
 27. The surgical instrument of claim 13,wherein the second engagement member includes a yoke to engage a rod ofthe articulation mechanism.
 28. The surgical instrument of claim 13,wherein the power pack is contained in the compartment out of contactwith body fluids of a patient, and the power pack is reusable.
 29. Thesurgical instrument of claim 13, wherein one or both of the power packor housing includes a sensor to indicate a position of articulation ofthe first and second jaws with respect to the longitudinal axis of theelongated member.
 30. The surgical instrument of claim 13, wherein thepower pack is removably loadable into the housing with the elongatedmember attached to the housing.
 31. The surgical instrument of claim 13,wherein the power pack is out of contact with the handle.
 32. Thesurgical instrument of claim 13, wherein pivoting of the cover with thepower pack loaded therein and the elongated member extending distallyfrom the housing does not affect the position of the elongated member.33. A surgical instrument comprising: a housing containing a compartmenttherein; an elongated member extending distally from the housing; a jawassembly including a first jaw and a second jaw at a distal portion ofthe elongated member, at least the first jaw movable with respect to thesecond jaw; a jaw clamping mechanism movable between a first positionand second position to move at least the first jaw toward the second jawto clamp tissue between the first and second jaws; an articulationmechanism positioned within the housing and movable between a firstposition and a second position to articulate the jaw assembly from alinear position to a second position angled with respect to alongitudinal axis of the elongated member; a cover on the housingmovable from a closed position to an open position to access thecompartment; and a power pack loadable into the compartment, the powerpack having a motor and an engagement member engageable with thearticulation mechanism within the housing to effect movement of thearticulation mechanism from the first position to the second position,wherein the power pack engages the articulation mechanism when loadedinto the compartment
 34. The surgical instrument of claim 33, whereinactuation of the motor converts rotary motion to linear motion withinthe power pack to move the engagement member linearly to thereby movethe articulation mechanism linearly to the second position.
 35. Thesurgical instrument of claim 33, wherein the articulation mechanism ispositioned within the housing when the power pack is loaded into thecompartment for engagement with the articulation mechanism.
 36. Thesurgical instrument of claim 33, wherein the elongated member isattached to the housing and extends therefrom when the power pack isloaded into the compartment.
 37. The surgical instrument of claim 33,wherein the power pack is top loaded into the compartment in a directiontransverse to the longitudinal axis of the instrument.
 38. The surgicalinstrument of claim 33, wherein the pivoting of the cover with the powerpack loaded therein and the elongated member extending distally from thehousing does not affect the position of the elongated member.